Numerous studies have shown that improving hand hygiene compliance and sustaining that improvement requires ongoing measurement of hand hygiene performance and direct feedback of results to healthcare workers. With traditional monitoring methods such as direct observation, the time and human resources required to effectively monitor performance and give timely feedback are difficult to sustain. This piece explores how powerful the impact of giving healthcare workers immediate, direct feedback is on improving and sustaining hand hygiene compliance. It also shows how electronic monitoring can free up infection preventionist resources to deliver that feedback and reinforces how important it is to monitor healthcare worker’s interactions with individual patients (patient zones) in order to get an accurate measure of compliance.